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Sent By: HP LaserJet 3100� 4258249516� Nov-29-05 ti :atAld; Page 't/3 <br /> PERMIT APPLICATION <br /> �s��r� CITY OF EVERETT PER��AIT SERVICES <br /> `c 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 ��79�5 <br /> SITE ADDRESS PARCEL TA?(I.D.�f PERMITY <br /> WA 9R201 0043916100::700 �j _ <br /> 2608 OAKF.S AVF.,EVf•.RE'I T, '� <br /> LEGAL LOT NO. BLOCK TRACT <br /> � PHONE <br /> OWNER ADDRESS <br /> 3v 15 1 I a S'C SP. (425)3 I a-6:8a <br /> UA��ISUN,STACY . EvL•iCETI',WA 48?OB <br /> TENANTNAME CONTACTNAME PHONE <br /> ��TAL(OCCUP1Ell) PAMF.I.A 11IL[. a25 8 ia•312y�i 33 <br /> CONTRACTOR ADDRESS CON7R.LICENSEp <br /> PASTWA7'ERIiFATCRCOMPANY 12601132hDAVF.NE fASI'W�IC052DF <br /> KIRKLAND,WA vau53 n2i16;?00� <br /> (A25)R14•51=4 <br /> PROPO&ED USE OF BUILDING ���a�^o w��n,ni�. WORK Addillon H �T souace <br /> PERMIT ComhlMHon Plumbiny - Alurdon ll�ctrlc <br /> TMpE D�molllbn Sipn NPE Ntw ac <br /> � R� IrMum u <br /> CONTRACT PRICE OF WORK 5449A0 :CITY OF �VEttETT LOCAL 3ALE3 TNf CODEIS]105 <br /> WORK DESCRIPTION Rcmovz/Rcplace G;u Water Hceter <br /> g� I�ECMANIGAL aF IXT R ITEM <br /> N pF R ITEM <br /> WATER CLOSET _____ AfC•NHANDLINO UNITS <br /> BATHTUB „___ FORCED AIR SYSTlM9 <br /> LAVATORY (WASM BASIN) _____ NEAT PUMP <br /> SHOWER __�_ UNIT HEATERS <br /> ^ KITCHEN SINK 3 DISPOSAL �.__ CLOTHE3 ORYER <br /> � DISHWosHER _ _ RAN(iE H000 <br /> � LAUNDRY TRAY � � _ WATER MCATER <br /> CLOTHES WASHER ___.� METAL FIREPLACFISTOVE <br /> � URINAL ______ FtREPLACE INSERT <br /> � DRINKING FOUNTAIN _ 6AS FIREPUCE <br /> � FLOOR DRAIN _ GAS RANGE <br /> � PAGK!'LOW PREVENTER __._ GAS PIPINf3 <br /> __ SINK (SERVICElBAR/MOPlETC.) _�_ EXHAUST fAN <br /> ^ OTHER O7NE11--------'-----^---- <br /> I NEREBY CERTIFY TNAT I NnVE READ AND El(�MINEDTHIS APLICATION 4ND KNOW THE SAME TO BE TRUE AND CORRECY,A�� <br /> PROVISIONS OF lAWS AyU ORD�NANCES GOVERNING THIS TYPE OF W�JRK WILL BE COIAPLIE�WIHT WliLTHER SPEGIFIED HEREI <br /> OR NOT,TNE GRANi1NG OF A PERMIT DOES N07 PRESUME TO GNE nU fHORITY TO VIOLATE OR GANCEL TNE PROVISION OF ANV <br /> OTNER STATE OR LOCAL LAW REGUV.TING CONSTRUCTION OR THG PERFORMANCE OF CONS�RUCTION.THAT I AM AUTHORIZEO <br /> BY THE OWNER Qf TNIS PROPERTY TO PERFORM TNE WORK FOR WHI�:NAPPLICATION IS I�MOE AND 1 COMPLY WRM TNE STATE <br /> CONTRACTORS LAW 1E.27 RCW AND 296200 WAC. <br /> � . Dat� Ilr'29R005 <br /> Sipn��uro of OwnadContro��orlAuthorized Ag��i .���� , ,ti. ,= � i <br /> ui!^i <br /> ----^— <br />